Skin and Soft Tissue Infections Caused by Methicillin-Resistant<i>Staphylococcus aureus</i>USA300 Clone

Johnson, J. Kristie; Khoie, Tina; Shurland, Simone M.; Kreisel, Kristen; Stine, O. Colin; Roghmann, Mary-Claire

doi:10.3201/eid1308.061575

Cited by 90 publications

(86 citation statements)

References 18 publications

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“…Previous reports suggest that men are at higher risk than women for S. aureus infections; therefore, our estimates may overestimate true rates for women (8,12,13). Second, although we did not perform molecular typing on the S. aureus-positive isolates, we expect that a signifi cant proportion (>80%) of noninvasive MRSA infections were caused by the USA300 MRSA strain (1). Given that USA300 MRSA reportedly varies across the United States, our fi ndings may not be generalizable to populations in which MRSA strains differ.…”

Section: Discussionmentioning

confidence: 84%

“…Our study identifi ed increases in noninvasive S. aureus infections, particularly around 2003, which most likely are associated with the emergence of the USA300 MRSA clone that has led to increases in community-associated MRSA, specifi cally in SSTIs (1,22). Also, despite dramatic increases in noninvasive community-onset MRSA infections, we did not observe a proportionate increase in invasive community-onset MRSA as might be expected if USA300 MRSA had the same propensity as non-USA300 MRSA to invade the bloodstream.…”

Section: Discussionmentioning

confidence: 99%

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Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Salam¹,

Khan²,

Malnick³

et al. 2011

Emerg. Infect. Dis.

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Trends in Staphylococcus aureus infections are not well described. To calculate incidence in overall S. aureus infection and invasive and noninvasive infections according to methicillin susceptibility and location, we conducted a 10-year population-based retrospective cohort study (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) using patient-level data in the Veterans Affairs Maryland Health Care System. We found 3,674 S. aureus infections: 2,816 (77%) were noninvasive; 2,256 (61%) were methicillin-resistant S. aureus (MRSA); 2,517 (69%) were community onset, and 1,157 (31%) were hospital onset. Sixty-one percent of noninvasive infections were skin and soft tissue infections; 1,112 (65%) of these were MRSA. Ten-year averaged incidence per 100,000 veterans was 749 (± 132 SD,

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Salam¹,

Khan²,

Malnick³

et al. 2011

Emerg. Infect. Dis.

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“…Of increasing concern is the rapidly rising frequency of ABSSSI caused by methicillin-resistant Staphylococcus aureus (MRSA). Particularly, the incidence of community-acquired MRSA (CA-MRSA) infections has risen dramatically since the beginning of this millennium (1,2). CA-MRSA is now the most common pathogen cultured from patients with ABSSSI in emergency departments in most U.S. cities (3).…”

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confidence: 99%

Antimicrobial Activity of the Pleuromutilin Antibiotic BC-3781 against Bacterial Pathogens Isolated in the SENTRY Antimicrobial Surveillance Program in 2010

Paukner

Sader

Ivezić-Schoenfeld

et al. 2013

Antimicrob Agents Chemother

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BC-3781 is a novel semisynthetic pleuromutilin antibiotic inhibiting bacterial protein synthesis. BC-3781 has completed a phase 2 clinical trial in acute bacterial skin and skin structure infections (ABSSSI). Its antibacterial spectrum additionally covers the predominant pathogens causing community-acquired bacterial pneumonia (CABP). In this study, the antibacterial activity of BC-3781 was evaluated against a contemporary collection of 10,035 bacterial isolates predominately causing ABSSSI and CABP, among other infections, collected within the SENTRY Antimicrobial Surveillance Program worldwide in 2010. BC-3781 exhibited potent activity against organisms commonly isolated from ABSSSI such as Staphylococcus aureus (MIC 50/90 , 0.12/0.12 g/ ml; 99.8% inhibited at <0.5 g/ml), beta-hemolytic streptococci (MIC 50/90 , 0.03/0.03 g/ml; 99.3% inhibited at <0.5 g/ml), and coagulase-negative staphylococci (CoNS; MIC 50/90 , 0.06/0.12 g/ml; 97.8% inhibited at <1 g/ml). BC-3781 displayed similar MIC distributions among methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) S. aureus strains. BC-3781 was also active against Enterococcus faecium, with 76.3% of vancomycin-susceptible and 97.0% of vancomycin-resistant isolates being inhibited at BC-3781 concentrations of <1 g/ml. Beta-hemolytic and viridans group streptococci were highly susceptible to BC-3781, with 99.3% and 96.7% of isolates inhibited at <0.5 g/ml, respectively. Further, activity of BC-3781 against Streptococcus pneumoniae (MIC 50/90 , 0.12/0.25 g/ml), Haemophilus influenzae (MIC 50/90 , 1/2 g/ml), and Moraxella catarrhalis (MIC 50/90 , 0.12/0.25 g/ml) was not negatively influenced by ␤-lactamase production or resistance to other antimicrobial classes tested. In all, BC-3781 displayed a very potent antibacterial profile including the most prevalent bacterial pathogens causing ABSSSI and CABP, thus warranting further clinical development of this antibiotic in these and possibly other indications.

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“…This strain is thought to have unique epidemiologic and clinical characteristics. It has been associated predominantly with skin and soft-tissue infections (7,15) but recently has also been described as a significant cause of health care-associated and nosocomial infections (17). BSIs have been less commonly reported (11,12,36).…”

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confidence: 99%

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Bloodstream Isolates in Urban Detroit

et al. 2008

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To gain a better understanding of epidemiology of resistance in Staphylococcus aureus, we describe the molecular epidemiology of methicillin-resistant Staphylococcus aureus bloodstream isolates in urban Detroit. Bloodstream isolates from July 2005 to February 2007 were characterized. Two hundred ten bloodstream isolates from 201 patients were evaluated. Patient characteristics were as follows: median age, 54 years; 56% male; and 71% African-American. Seventy-six percent of infections were health care associated, with 55% being community-onset infections and 21% hospital acquired, and 24% were community associated. The most common sources were skin/wound (25%), central venous catheters (24%), unknown source (20%), and endocarditis (9%). Ninety percent and 5% of isolates had a MIC of vancomycin of <1.0 mg/liter, using automated dilution testing and E-test, respectively. Six percent of isolates showed heteroresistance to vancomycin, all occurring with isolates having a vancomycin E-test MIC of >1.5 mg/liter. Results of pulsed-field gel electrophoresis showed 17 strain types. The predominant strains were USA100 (104 isolates) and USA300 (74 isolates). Forty-nine percent of the isolates had staphylococcal cassette chromosome mec II, and 56% had agr II. All USA300 isolates were positive for the PantonValentine leukocidin toxin genes and agr I. Forty-seven percent of USA300 bloodstream infections were health care associated (35% community onset and 12% hospital onset). USA300 strains were more common in injection drug users with skin/wound as the predominant source of infection. Thirty percent of the USA100 strains were closely related to vancomycin-resistant Staphylococcus aureus isolates. The results of this study show that vancomycin MICs using automated dilution testing with Vitek-2 and E-test were highly discordant. Most methicillin-resistant S. aureus strains causing bacteremia are health care associated, commonly have MICs of vancomycin that are high within the susceptible range are not detected by routine automated dilution testing, and have significant diversity of molecular characteristics. USA100 strains that are closely related to vancomycin-resistant S. aureus (VRSA) isolates and USA300 strains are common as causes of both hospital and community-onset infection. Infection control measures should focus not only on prevention of the spread of community strains in the hospital but also prevention of the spread of hospital strains associated with VRSA into the community.

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Skin and Soft Tissue Infections Caused by Methicillin-ResistantStaphylococcus aureusUSA300 Clone

Abstract: An increase in SSTIs suggests that USA300 is becoming more virulent with a greater propensity to cause SSTIs.

Cited by 90 publications

References 18 publications

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Staphylococcus aureusInfections in US Veterans, Maryland, USA, 1999–20081

Antimicrobial Activity of the Pleuromutilin Antibiotic BC-3781 against Bacterial Pathogens Isolated in the SENTRY Antimicrobial Surveillance Program in 2010

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Bloodstream Isolates in Urban Detroit

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